Implementation of Brief Interventions Into Clinical Practice

Historically, a 17-25 year gap has been identified from the time evidence is established for a psychological intervention to implementation of the intervention in clinical practice. Even when a mental health intervention is implemented in practice, program sustainability is difficult, with one study finding only 47% of services maintained fully implemented evidence-based interventions for 6 years. Hence, even if brief interventions are found to be effective modes of treatment for alcohol, it is necessary to also consider whether they can feasibly be implemented as part of routine care. 

While brief interventions have been implemented across multiple settings, with different countries adopting national strategies to support their implementation, a number of challenges have been identified. Common barriers that impact screening rates and the effective delivery of brief interventions include lack of time, competing commitments, and adequate space. Facilitators to implementations include: having interdisciplinary teams conduct the screening; having a brief screening tool which is integrated in routine care and existing electronic systems; having onsite specialists, who are integrated with existing service teams, conducting brief interventions on site or over the phone to increase client engagement, as well as ensuring that there is a feedback loop post-intervention to the referrers. Having a start-up phase to the implementation and adopting multiple types of intervention strategies that focus on the professionals, organisations and clients/patients. Finally having a clear monitoring system, clear targets, and a “champion” in a leadership position who provides logistical and problem-solving support as well as charisma and strong consistent messaging. These barriers and facilitators need to be considered and actively addressed to facilitate the efficient and effective implementation of BIs.